Operating room scheduling and rescheduling: a rolling horizon approach

Abstract

In this work we consider the problem of selecting a set of patients among a given waiting list of elective patients and assigning them to a set of available operating room blocks. We assume a block scheduling strategy in which the number and the length of available blocks are given. As each block is related to a specific day, by assigning a patient to a block his/her surgery date is fixed, as well. Each patient is characterized by a recommended maximum waiting time and an uncertain surgery duration. In practical applications, new patients enter the waiting list continuously. Patient selection and assignment is performed by surgery departments on a short-term, usually a week, regular base. We propose a so-called rolling horizon approach for the patient selection and assignment. At each iteration short-term patient assignment is decided. However, in a look-ahead perspective, a longer planning horizon is considered when looking for the patient selection. The mid-term assignment over the next $n$ weeks is generated by solving an ILP problem, minimizing a penalty function based on total waiting time and tardiness of patients. The approach is iteratively applied by shifting ahead the mid-term planning horizon. When applying the first week solution, unpredictable extensions of surgeries may disrupt the schedule. Such disruptions are recovered in the next iteration: the mid-term solution is rescheduled limiting the number of variations from the previously computed plan. Besides, the approach allows to deal with new patient arrivals. To keep limited the number of disruptions due to uncertain surgery duration, we propose also a robust formulation of the ILP problem. The deterministic and the robust formulation based frameworks are compared over a set of instances, including different stochastic realization of surgery times.